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Eli's Rehab Report

You Be the Coder:

Emergency During Office Visit

Published on Sun Oct 01, 2000

Question: We had an emergency situation in our office when a patient had a seizure during an exam, fell and hit his head on the floor. The doctor administered emergency care while waiting for the ambulance. The established patient evaluation and management visit codes dont seem appropriate, but neither do the codes for emergency department visits. How should we code this?

Wisconsin Subscriber


Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.




Answer: The most appropriate code is CPT 99215 (office or other outpatient visit for the evaluation and management of an established patient; presenting problems are usually of moderate to high severity). The situation probably does not warrant critical care services (99291-99292), and the emergency department codes (99281-99285) cannot be billed in the physicians office.

Answer was provided by Brenda Messick, CPC, senior consultant at Gates, Moore & Co., a physician practice management and reimbursement consulting firm in Atlanta.



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